University of Toronto, Toronto, ON, Canada.
Virulence. 2013 Aug 15;4(6):543-55. doi: 10.4161/viru.25949. Epub 2013 Aug 2.
Malaria affects millions of people around the world and a small subset of those infected develop cerebral malaria. The clinical presentation of cerebral malaria differs between children and adults, and it has been suggested that age-related changes in the endothelial response may account for some of these differences. During cerebral malaria, parasites sequester within the brain microvasculature but do not penetrate into the brain parenchyma and yet, the infection causes severe neurological symptoms. Endothelial dysfunction is thought to play an important role in mediating these adverse clinical outcomes. During infection, the endothelium becomes activated and more permeable, which leads to increased inflammation, hemorrhages, and edema in the surrounding tissue. We hypothesize that post-natal developmental changes, occurring in both endothelial response and the neurovascular unit, account for the differences observed in the clinical presentations of cerebral malaria in children compared with adults.
疟疾影响着全球数百万人，其中一小部分感染者会发展为脑型疟疾。脑型疟疾在儿童和成人中的临床表现有所不同，有人认为，内皮反应的年龄相关变化可能是造成这些差异的部分原因。在脑型疟疾中，寄生虫在脑微血管中隔离，但不会穿透脑实质，然而，感染会导致严重的神经症状。内皮功能障碍被认为在介导这些不良临床结局中起着重要作用。在感染过程中，内皮细胞被激活，通透性增加，导致周围组织的炎症、出血和水肿增加。我们假设，内皮反应和神经血管单元中发生的出生后发育变化，解释了儿童与成人脑型疟疾临床表现差异的原因。
